The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
25
06
2021
accepted:
17
08
2021
entrez:
8
9
2021
pubmed:
9
9
2021
medline:
23
11
2021
Statut:
epublish
Résumé
Recent findings from several studies have shown that paramagnetic rim lesions identified using susceptibility-based MRI could represent potential diagnostic and prognostic biomarkers in multiple sclerosis (MS). Here, we perform a systematic review and meta-analysis of the existing literature to assess their pooled prevalence at lesion-level and patient-level. Both database searching (PubMed and Embase) and handsearching were conducted to identify studies allowing the lesion-level and/or patient-level prevalence of rim lesions or chronic active lesions to be calculated. Pooled prevalence was estimated using the DerSimonian-Laird random-effects model. Subgroup analysis and meta-regression were performed to explore possible sources of heterogeneity. PROSPERO registration: CRD42020192282. 29 studies comprising 1230 patients were eligible for analysis. Meta-analysis estimated pooled prevalences of 9.8% (95% CI: 6.6-14.2) and 40.6% (95% CI: 26.2-56.8) for rim lesions at lesion-level and patient-level, respectively. Pooled lesion-level and patient-level prevalences for chronic active lesions were 12.0% (95% CI: 9.0-15.8) and 64.8% (95% CI: 54.3-74.0), respectively. Considerable heterogeneity was observed across studies (I2>75%). Subgroup analysis revealed a significant difference in patient-level prevalence between studies conducted at 3T and 7T (p = 0.0312). Meta-regression analyses also showed significant differences in lesion-level prevalence with respect to age (p = 0.0018, R2 = 0.20) and disease duration (p = 0.0018, R2 = 0.48). Other moderator analyses demonstrated no significant differences according to MRI sequence, gender and expanded disability status scale (EDSS). In this study, we show that paramagnetic rim lesions may be present in an important proportion of MS patients, notwithstanding significant variation in their assessment across studies. In view of their possible clinical relevance, we believe that clear guidelines should be introduced to standardise their assessment across research centres to in turn facilitate future analyses.
Sections du résumé
BACKGROUND
Recent findings from several studies have shown that paramagnetic rim lesions identified using susceptibility-based MRI could represent potential diagnostic and prognostic biomarkers in multiple sclerosis (MS). Here, we perform a systematic review and meta-analysis of the existing literature to assess their pooled prevalence at lesion-level and patient-level.
METHODS
Both database searching (PubMed and Embase) and handsearching were conducted to identify studies allowing the lesion-level and/or patient-level prevalence of rim lesions or chronic active lesions to be calculated. Pooled prevalence was estimated using the DerSimonian-Laird random-effects model. Subgroup analysis and meta-regression were performed to explore possible sources of heterogeneity. PROSPERO registration: CRD42020192282.
RESULTS
29 studies comprising 1230 patients were eligible for analysis. Meta-analysis estimated pooled prevalences of 9.8% (95% CI: 6.6-14.2) and 40.6% (95% CI: 26.2-56.8) for rim lesions at lesion-level and patient-level, respectively. Pooled lesion-level and patient-level prevalences for chronic active lesions were 12.0% (95% CI: 9.0-15.8) and 64.8% (95% CI: 54.3-74.0), respectively. Considerable heterogeneity was observed across studies (I2>75%). Subgroup analysis revealed a significant difference in patient-level prevalence between studies conducted at 3T and 7T (p = 0.0312). Meta-regression analyses also showed significant differences in lesion-level prevalence with respect to age (p = 0.0018, R2 = 0.20) and disease duration (p = 0.0018, R2 = 0.48). Other moderator analyses demonstrated no significant differences according to MRI sequence, gender and expanded disability status scale (EDSS).
CONCLUSION
In this study, we show that paramagnetic rim lesions may be present in an important proportion of MS patients, notwithstanding significant variation in their assessment across studies. In view of their possible clinical relevance, we believe that clear guidelines should be introduced to standardise their assessment across research centres to in turn facilitate future analyses.
Identifiants
pubmed: 34495999
doi: 10.1371/journal.pone.0256845
pii: PONE-D-21-20493
pmc: PMC8425533
doi:
Substances chimiques
Biomarkers, Tumor
0
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0256845Subventions
Organisme : Medical Research Council
ID : MR/L023784/2
Pays : United Kingdom
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Res Synth Methods. 2019 Sep;10(3):476-483
pubmed: 30945438
J Clin Invest. 2016 Jul 1;126(7):2597-609
pubmed: 27270171
AJNR Am J Neuroradiol. 2020 Jun;41(6):1001-1008
pubmed: 32439639
Mult Scler. 2019 Dec;25(14):1915-1925
pubmed: 30566027
Lancet Neurol. 2019 Feb;18(2):198-210
pubmed: 30663609
JAMA. 2000 Apr 19;283(15):2008-12
pubmed: 10789670
Nat Rev Neurol. 2019 Oct;15(10):582-593
pubmed: 31420598
J Magn Reson Imaging. 2015 Jul;42(1):224-9
pubmed: 25174493
Curr Opin Neurol. 2020 Aug;33(4):422-429
pubmed: 32657883
PLoS One. 2013;8(3):e57573
pubmed: 23516409
Sci Rep. 2019 Dec 3;9(1):18188
pubmed: 31796822
J Magn Reson Imaging. 2015 Jul;42(1):23-41
pubmed: 25270052
Front Immunol. 2018 Feb 19;9:255
pubmed: 29515576
Mult Scler. 2021 Apr 19;:13524585211010082
pubmed: 33870790
Acta Neuropathol. 2018 Apr;135(4):511-528
pubmed: 29441412
Acta Neuropathol. 2017 Jan;133(1):13-24
pubmed: 27988845
J Clin Neurol. 2020 Oct;16(4):562-572
pubmed: 33029961
Mult Scler. 2020 Sep 23;:1352458520958589
pubmed: 32965168
Acta Neuropathol. 2017 Jan;133(1):25-42
pubmed: 27796537
Mult Scler Relat Disord. 2020 Oct;45:102317
pubmed: 32615504
Ann Neurol. 2020 Nov;88(5):1034-1042
pubmed: 32799417
Magn Reson Imaging. 2015 Jan;33(1):1-25
pubmed: 25267705
Br J Radiol. 2019 Sep;92(1101):20181016
pubmed: 30933548
Nat Rev Neurosci. 2004 Nov;5(11):863-73
pubmed: 15496864
Cold Spring Harb Perspect Med. 2018 Mar 1;8(3):
pubmed: 29358320
BMJ. 2009 Jul 21;339:b2535
pubmed: 19622551
Brain. 2021 Jul 28;144(6):1684-1696
pubmed: 33693571
J Epidemiol Community Health. 2013 Nov 1;67(11):974-8
pubmed: 23963506
JAMA Neurol. 2019 Dec 1;76(12):1474-1483
pubmed: 31403674
Brain. 2011 Dec;134(Pt 12):3602-15
pubmed: 22171355
Curr Opin Neurol. 2021 Aug 1;34(4):505-513
pubmed: 33928930
Ann Neurol. 2015 Nov;78(5):710-21
pubmed: 26239536
AJNR Am J Neuroradiol. 2018 Jul;39(7):1233-1238
pubmed: 29724768
MAGMA. 2016 Jun;29(3):543-57
pubmed: 27112155